What are common technical errors in central venous access the subclavian vein?

Updated: Aug 07, 2018
  • Author: E Jedd Roe, lll, MD, MBA, FACEP, FAAEM, MSF, CPE; Chief Editor: Vincent Lopez Rowe, MD  more...
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Answer

Kilbourne et al analyzed failed subclavian catheter placement attempts by resident physicians in an effort to describe common technical errors and to direct future teaching strategies. [12] Subclavian cannulations were videotaped. Analysis of 86 patients revealed six common errors in technique that occurred over 277 attempts (see Table 1 below).

Table 1. Common Errors in Technique (Open Table in a new window)

Error

Percent of Failures (N = 277)

Inadequate landmark identification

14.7

Improper insertion position

32.3

Insertion of needle through periosteum

21.9

Taking too shallow a trajectory with needle

16.1

Aiming the needle too cephalad

7.5

Failure to keep needle in place for wire passage

7.5


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